MY MOTHER’S FINAL HOUR

by Cathy Arden on June 8, 2015

I knew it was the last day. I had known for a week that it was coming, although no one had told me. Not the hospice nurses, not the Board and Care aides, not the hospice doctor. But I had told them, “She’s dying now.” There was a change. This was the end. I knew. I mean, how closely had I been watching my mother for eleven years? There wasn’t anything about her physical presence I was not aware of. We were connected at the hip when I was a child, merged in ways I had to break away from when I was an adult, and then merged again when she became ill and I was the only person she had left to rely on. There we were in her last years, an amalgam of mother and daughter sinew, devotion in its most primal elements.

It is impossible to count the goodbyes. But count all the days there are in eleven years. Then multiply those days by many more numbers because sometimes I’d have to say goodbye to my mother more than once a day. Leaving her was always a treacherous endeavor. This could be it. Today. Or tomorrow. Or tonight. Maybe this is the last goodbye. Maybe it’s this goodbye. Maybe this one. Maybe. Tell her you love her. Rub her head because she loves that. This may be the last time you have that chance.

And if I had to travel out of the country, I had all the details arranged, the details of her death. Mortuary contracts, caregiver instructions, financial papers organized, estate lawyers informed, my own personal lists of who to contact – her friends, my friends. Call me at any hour. That was my mantra for eleven years. I slept with a cell phone on the mattress next to me. No matter where in the world I was, there were only inches between me and a cell phone at all times.

I moved through my mother’s last day as if it wouldn’t end, as if it wasn’t the last day at all. Just as I had the past eleven years of days of her dementia and steady physical decline and illness. Although I expected my mother to die on a daily basis for so many years, so many days, I also didn’t expect her to go. I anticipated it. I just didn’t expect it. I believe there is a difference. This was the dichotomy that absorbed my psyche for eleven years. Emergency after emergency, procedure after procedure, ICU’s, ER’s, surgeries, round the clock care. For eleven years, close calls were the norm. Doctors and nurses and aides preparing me for the worst was a common occurrence. I believed I was truly prepared. But like an expectant mother who is soon to give birth for the first time, you know birth is inevitable but you don’t know what awaits you on the other side of that event. And you certainly don’t know what that event will be like. Anticipating death is like that. I had experienced the deaths of loved ones before — my sister, my father – but my mother’s MO was not to let go. It was to hold on, to survive against all odds over the course of so many years being ill and unaware of her own illness. And my MO was to be the forever caregiver, the staunch trooper, the soldier who forges ahead under any circumstance, dealing with all the details of illness and care and impending death. I had every detail under control. Over the course of eleven years doing a job, you become quite expert at it.

“Only a bazooka will take her out, “ my 22-year-old son declared after the last time he saw his grandmother, which as it turns out, really was the last time. “I used to think she was going to die,” he said, “but now I’m not so sure.” And he added, “By the way, Mom, if this ever happens to you, you’re outa here.” “How so?” I asked. My mother had always told me that if she were ever to become “non compis mentis,” as she liked to put it, “Just shoot me.” I remind my son that euthanasia for humans is illegal. “No,” he explained, “ I’ll just put you in the backseat of my car and drive you to Oregon if that’s what it takes. Not to worry.”

My son believes I kept his grandmother alive for more years than she should have been on this earth, given her compromised mental and physical condition and the fact that she never wanted to live in such a dependent state. It’s interesting to me that he believes I had this kind of power and control over my mother’s life. “Did you want me to kill her?” I ask him, in all seriousness. “Come on, Mom, you kept her alive.” He says it like it’s an accusation. He’s as horrified as I am that my mother continued to live in such a diminished state for so long. And yet the light remained in her eyes until the end, and although her raucous laugh became subdued, her sense of humor never wavered. I could always get her to smile. And if her appetite waned, a hearty bagel, lox and cream cheese sandwich with some herring in cream sauce resolved that issue every time. Miraculously, when so much of her mind went into hiding, she still knew who I was and who her grandchildren were. She’d be transformed whenever she saw us. “You’re so handsome,” she’d tell my son, continuously. And when she saw my daughter, whose birth she had always said healed her heart after the death of my sister, a smile would stay plastered on her face for the entire visit. So shoot my mother? She simply continued to live all those years. She looked near death to all of us, but she lived in some sacred space that continued to breathe life into her. Either this world held her, or she held this world. I don’t know which power was greater.

I had two appointments on that last day. I felt foolish and somewhat crazy keeping them. But although I knew this must be the last day, I also didn’t know this. One appointment was with a couple interested in renting my guest house, and another was with my dermatologist.

My mother’s caregivers did not get her out of bed for a shower or breakfast that morning. She was sleeping, they told me. The night before I had called the hospice nurse to come and give her morphine. I knew she was in pain. I saw it in her eyes. She grabbed my hand and looked straight at me. And for the few weeks before that she had been doing the same and saying the words, “Don’t leave me. Don’t leave me.”

I stayed with my mother for awhile that morning as she slept. I thought perhaps she’d wake up after the morphine wore off. But a hospice nurse told me she wasn’t sleeping because of the morphine they had given her the night before. My mother wasn’t waking up and she had always woken up. Every morning. If it wasn’t the morphine, then in my estimation, it could only be one thing. This was the day.

My appointment with the dermatologist was at 1PM. I could have canceled the appointment but it was within walking distance of my mother, so I decided I should go. If you act normal, perhaps life will normalize around you. I kept the phone in my hand as the doctor froze whatever it was on my face.

I ran home to walk my dog. I had to meet the prospective renters on a street corner near my house as they didn’t have my address for various safety reasons. I stood on that street corner with my dog and I waited and I waited and I waited. I tried to reach them but they didn’t pick up, they didn’t respond to text messages. In fact, they never showed up. “You fucking idiots,” I said aloud, standing on that corner with my dog. “My mother is dying and I’m standing here for no reason.”

The hospice nurse was due to arrive at 4PM. I knew I couldn’t park on my mother’s street again until that time due to street cleaning and parking regulations. My plan was to make it there by 4 as well. The hospice nurse would be arriving to begin what they call continuous care. Continuous until the end.

I arrived just minutes after the hospice nurse. When I walked into my mother’s bedroom, I heard the sound I had never heard before. My mother’s breathing. Like deafening ocean waves breaking on boulders. So loud, so demanding. The sound took hold of me. There was nothing else. I saw the nurse standing over my mother’s hospital bed. I managed to climb into the hospital bed over the metal rail and wrap myself around my mother. I was sandwiched between my mother and the wall. I spoke softly into my mother’s ear as the nurse spoke calmly and consistently to me, explaining what was happening because she knew I was in a panic state. “She’s in pain,” I kept repeating to the nurse. “Please give her something. You have to give her something. I don’t want her to suffer.”

This. This had always been my prayer. PLEASE DO NOT LET HER SUFFER. I said that prayer as many times as I had said goodbye.

I had to speak loudly above her breathing to the nurse because her breathing was louder than anything else in the world. “Listen carefully,” the nurse said with great compassion. “That sound is your mother exhaling. If the sound occurred on the inhalation, she’d be in distress. She’s not in pain. This is normal. This is how it happens. The sound will get softer and softer as her breathing slows down. It will get slower and quieter. Until she takes her last breath.”

Somewhere in that hour I called my daughter from my mother’s bed. I started crying when she picked up.

“She’s dying now.”
“Are you sure? We’ve thought this before.”
“No. This is it. It’s happening right now.”
“Tell her I love her,” my daughter said, crying with me. “I’m getting in my car now, Mom. I’ll be there in a couple of hours.”

My daughter lives in San Diego, my son was living in France at the time. I didn’t call him at that moment as it was close to 2AM in France. But we had spoken earlier and he had relayed the same message. Tell her I love her. I was telling my mother we all loved her as I stroked her arms, her face, rubbed her head, soothing her with my hands, my voice, my body, speaking softly into her ear to be heard above the sound of her loud exhalations during that last hour. I named every person I could think of whom she had loved and who had loved her and all of those people who were waiting for her on the other side. “It’s okay, Mom, you can go now. I’ll be okay. We’ll be okay. We love you. We will always love you. Please let go now. It’s okay. You can go.” And maybe, just maybe, even though she could not express it during that last hour, maybe her humor was still inside. I repeated what I said to her hundreds of times over the last years, as it had always made her laugh. “Mom, you’re going to see the whole mishpocha! They’ve been waiting for you for so long!” Mishpocha is Yiddish for family. Come to the end with humor. That can’t be bad. I pulled up one of the few Yiddish words I knew to bond with my mother one last time before she died.

I kept hearing the nurse’s soothing explanation of what was happening. My mother’s breathing grew quieter and quieter and slower and slower. And as it did my body relaxed into hers. I felt less frantic. We were both letting go. Everything stopped. My mother was lying next to me. She was still my mother. But she was no longer there.

Eleven years and now I have stopped counting. Eleven years of illness. Eleven years of caretaking. Eleven years of questioning why. We want to make sense out of everything. Name everything in our midst. Control the universe with explanation and definition. Why had my mother lived in such a diminished state for so long? Why did my sister die of breast cancer at age 33? And if we can’t make sense of it, at least, we hope, we can learn from it. I am someone who has always been searching for clues to the meaning of tragedy.

I was expecting an abyss of grief to envelop me when my mother died. Perhaps the way it did when my sister died. But I have discovered that grief caused by tragedy is very different than other types of grief. The deaths of loved ones are not created equally. I am relieved I no longer have to say goodbye to my mother. I have never felt anything like that in the thirty-four years since my sister’s death.

My mother was 91 when she died on January 27th, 2015. My sister was 33 when she died on March 22nd, 1981. I have carried my sister around with me all these years, and I will continue to do so I’m sure. This is not a burden. It has breathed life and hope and optimism and courage into every part of my life, everything I do. Grief from her loss will also stay with me until the day I die. It can be no other way. When I scattered my mother’s ashes last month, I seemed to have also let go of grief over losing her eleven years ago. I’ve been mourning that loss for eleven years. My mother and I are merged in imperceptible ways now that only people who were close to us both would notice.

I am the spiritual caretaker for my sister. It was meant for me to carry her in this way. I am rightfully obligated to do so. I am no longer the caretaker for my mother. I don’t need to be. She was able to live her life fully and leave behind a legacy for so many. I held her close, we shared our breathing up until the end. And then I let her go.

HOW WE ARE SPARED

At midsummer before dawn an orange light returns
to the mountains
Like a great weight and the small birds cry out
And bear it up

My most sincerest condolences with your loss. This was beautifully written and I am glad that you were able to experience her dying with a greater sense of closure. The loss of your sister at her very young age may always be difficult to find closure for.

Cathy,
What a wonderful tribute and description. I can personally identify, and I think showing it to my clients who have similar situations would be helpful to them. May I do this with proper attribution?
Love,
Susana

Thank you, Susana. Yes, by all means,feel free to share with your clients. I’m also a Life Coach (http://cathyarden.com/lifecoach/), so feel free to direct anyone to me that you feel could use guidance and help through either this type of difficult situation, or any other. Much love to you –Cathy

Dear Cathy:
Thank you for sharing your love and passion for your mother so eloquently. I have experienced loss as well, my mother, father, husband and son, and understand pain that is wrapped in intimacy. You made me pause, think and remember, again and again.
My sincerest condolences.
Thank you,
Hanne

I felt very close yo Sherry, reading this, Cathy, and cried, hanging in there every suspensefulmmoment. I am so gratedful you got i that bed and held her as she let us and went back to God. Bless you, Cathy, and thanks for sharing this powerful piece.